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From transcribe
- Name in full Mrs Coutts Mary Ellen Blanche
- Date of birth Day 28 Month 10 Year 1883
- Place of birth Portage La Prairie Man
- Maiden name Smith
- Husband's given names William Smith Coutts deceased
- Father Lawrence Smith
- Mother Elizabeth Ellen Albright
- Given names of brothers or sisters Andrena A Nelson J William L
- Frederick E all deceased